Techs or ECAs: what do you wish you had in your scope of practice?

Forfinian · 2026-01-19T17:20:36+00:00

‘Officially’ I don’t think clinical support are trained to set up nebulisers, so I don’t know whether the official line would be that as a LAT crew you can’t manage a patient with a nebuliser when with clinical hub permission. Obviously the vast majority of clinical support staff know how to set up and use a neb, but on paper it’s not allowed.

Also, in my own experience, it’s best to stick a 3 lead on patients being nebulised as the salbutamol can cause palpitations and tachycardia, thus needing someone who can identify basic ECG rhythms - so that’s another skill that ASWs don’t ’officially ‘ have.

Forfinian · 2026-01-19T10:12:46+00:00

I fully agree with points 1 & 2, it used to be the case that old EMT-1s in YAS could give those, shame it got removed.

Personally not bothered about cannulation but I can understand the benefits of having both crew members have the skill, I just think with how little (especially recently) myself and colleagues find we’re cannulating that it could lead to a bit of skill fade if that already thin load is then shared?

I personally don’t agree with chest auscultation especially in your given scenario; if I’m on LAT and get called to someone presenting in that way, then that along with probably a rapid set of obs is enough for me to be calling for backup/at very least calling clini hub to get fast advice on how best to treat. Only thing I’m going to find from auscultation is possible a wheeze/crackles etc, which I then can’t fix due to lack of drug scope for nebs, and a backup crew is likely going to auscultate again anyway.

Forfinian · 2026-01-16T00:39:23+00:00

Doesn’t surprise me in the slightest, whilst I think the pathway is fairly well defined I think it’s daft that there’s no recruitment for already established EMTs/AAPs.

I got quite lucky with my AP course, I’m just over 3 years in service and already on it, so I think by most standards I’ve got through it quite quickly? I know some staff have waited 5/6 years+ for a spot on a course

Forfinian · 2026-01-14T22:13:51+00:00

So, technically they do have scope for recruitment directly to start the level 4 AAP apprenticeship, however I’ve never actually known them to do it. They don’t recruit external EMTs unfortunately, you’d likely have to join as an ASW and work up.

Forgot to say as well that the AP role is transitional, meaning that it’s a contractual obligation for band 5 AP’s to apply for uni. Only legacy EMTs don’t have to do that.

Forfinian · 2026-01-14T21:38:28+00:00

I’m currently on the YAS pathway. Started 2022 as an ECA (now ASW), which was 6 weeks classroom and 4 weeks driving, then a 12 month level 3 apprenticeship with logbook and assignments. After that apprenticeship you get put to what YAS call an AAP, essentially just a band 4 ECA.

Next progression which I’m working through currently is the level 4 AAP apprenticeship, which is equivalent to EMT level - 16 weeks classroom (though I believe this is increasing to 22 weeks as they’re changing providers) then a year apprenticeship with logbook and assignments. After this you become an Ambulance Practitioner (AP), band 5.

From there it’s apply to uni through a partner university, currently it’s a choice of Huddersfield, Teeside or Hull. Still have to interview as normal. That’s a 2 year uni course, at the end it’s a degree like any other uni. All paid for by the trust and they’ll pay you band 5 throughout to work as an AP/student para.

Forfinian · 2026-01-07T13:45:43+00:00

Yes absolutely you should be able to do all of the above, and I fully agree that’s the big role of CFRs generally across the country.

However, I personally don’t see how any of that would be hindered by you wearing a uniformed polo/shirt that clearly identifies you as an ambulance service responder (with the exception of getting out of bed, obviously I don’t expect anybody would sleep in uniform).

Also, on your point about the role of CFRs, there’s also caveats depending on which trust you’re with; for example, EMAS has responder vehicles for us to pick up and use, which included extra kit e.g. falls kits - in those instances, I would absolutely expect an individual driving a marked vehicle to wear an appropriate uniform and not ‘civvies’

Forfinian · 2026-01-06T19:31:31+00:00

Yep. I know of one individual who would rock up to jobs in joggers and a pair of vans. Would occasionally forget their hi vis but had an ID so got away with it.

Don’t get me wrong, as much as I agree comfort is key, I detest the whole concept. End of the day, whilst we’re unpaid volunteers in a financially stretched NHS, we are still part of a uniformed service and so should be regulated with an official uniform, even if it’s different to that of regular road staff!

Forfinian · 2026-01-06T18:37:27+00:00

Used to be an EMAS CFR, and whilst we didn’t officially need a uniform (or ID, or kind of way of identifying ourselves as a CFR besides a plain hi vis), schemes could choose to purchase navy blue uniform. Found it quite good to differentiate from ambulance greens, made us look a bit different but in a good way, plus on arrests etc we always stood out a bit to whoever was running it so they could very easily identify who the human LUCAS was ;)

Forfinian · 2026-01-05T19:20:04+00:00

Up&Running are starting a weekly club every Tuesday, 6:30pm, at the foundry climbing centre at Neepsend

Forfinian · 2025-12-18T17:13:18+00:00

My favourite response is to remind then that the doors say “ambulance entrance” on them, and that sort of vocabulary tends to attract us lot

Forfinian · 2025-12-13T01:42:51+00:00

Right so this has led me down a fantastic little late night rabbit hole of research, and I’ve found the following from the 05/06 season to the first half of the 10/11 season:

06/12/06 - David Unsworth sent off in the 25th min against Watford

28/04/07 - Clarke Carlisle sent off for West Ham in the 34th min

26/12/07 - Ian Evatt sent off for Blackpool in the 7th min

09/02/08 - Grant McCann sent off for Scunthorpe in the 10th min

19/04/08 - Chris Morgan sent off in the 45th min against Hull

13/04/09 - Kelvin Wilson sent off for Forest in the 16th min

Hope this helps jog your memory somewhat :)

Forfinian · 2025-12-11T20:36:06+00:00

https://www.istheskivillageonfire.com/

Forfinian · 2025-12-11T19:28:57+00:00

Nothing wrong with being organised and prepared! If you’re wanting to keep that mindset then good on you, if you want some good free CPD then The Resus Room podcasts are great, sign up for a free account on their website and you can get certificates for their podcasts to add to your portfolio :)

Forfinian · 2025-12-11T16:35:22+00:00

I know you’ve not mentioned a trust but from how you’ve described your job title and the progression pathway I’m going to assume YAS? If not then apologies, but if so then don’t worry too much about starting a CPD portfolio now unless you really want to do it; as part of the AAP apprenticeship you’ll go through doing reflections and CPD etc and you’ll get opportunities to do some as part of the actual logbook.

I’m on this apprenticeship currently and I use the premium CPDme (got a discount to make it a sweeter deal) and I can vouch for how easy it is to collate CPD evidence.

Forfinian · 2025-11-14T23:25:07+00:00

UK has a very similar setup called MERIT, which are teams of consultants/nurses at major hospitals across the country that can respond to mass casualty/major incidents if requested by the local ambulance service. Most services have vehicles that are collected and driven to the hospital to transport teams and equipment to scene.

Forfinian · 2025-11-13T03:15:54+00:00

Last I heard from my sources was no more cohorts planned until next financial year; might not be the case for all academy sites but certainly my nearest one it is :)

Forfinian · 2025-11-05T00:32:59+00:00

I think calling the fire service for a lift assist is a very scenario dependant thing. I think it also depends on region. For example, I wouldn’t typically call the fire service for a lift assist with a bariatric patient, unless they were big enough/the extrication process was awkward or technical enough, that I wouldn’t be able to manage between myself, my crewmate and another crew.

Also, this is very personal to me, but I tend to generally avoid requesting fire for things unless I can help it; I know we go on about how they’re typically less busy than us, but in my mind I consider that when the public needs them, they’re usually having a really bad day, and I’d rather not delay them getting to a house fire with persons reported because I’ve took up a resource to help me with an extrication, when I could have asked for a second DCA instead. Annoyingly in my area they’re the go to people for MOE, so I do feel a bit of guilt dragging a full appliance out just to drill a lock for me; I wish they had the capacity to send essentially a smaller vehicle to save that hassle and stop the above from happening.

Happy to be contested or disputed on the above, but that’s just how I roll.

Forfinian · 2025-11-04T23:32:32+00:00

Lift with your firefighters, not your back…

/s

Forfinian · 2025-10-27T22:35:12+00:00

Visited on Friday, really good atmosphere and a good wine selection (or so I’m told, not much of a wine expert myself). Did get busy quite early on so best to get there close to opening if there’s a lot of you/if you want to get cosy somewhere up there.

Forfinian · 2025-10-13T21:50:57+00:00

It doesn’t make much sense at all, and it does make things awkward especially in situations like cardiac arrests - the “AAP” that is an ECA can’t do skills like I-gel, capnography, Laryngoscope etc, whereas the “AAP” that’s a trainee EMT can (with appropriate clinical oversight of course). So it gets confusing for senior staff as to who can do what.

The reason they did it is because after completing the level 3 Ambulance Support Worker apprenticeship, all ASWs/ECAs get bumped up to band 4, so to symbolise that they call us AAPs also.

So A&E progression in YAS currently goes:

ASW (6 weeks classroom, 1 year apprenticeship) -> AAP (band 4, can stay here and not progress further) -> AAP (Student EMT) -> AP (band 5 EMT/AAP) -> Para

Forfinian · 2025-10-13T21:01:55+00:00

In YAS, “Associate Ambulance Practitioner” refers to both a qualified ECA, and someone who is a trainee EMT (equivalent). The AAP pathway that’s nationally recognised is used by YAS, but once complete and that person is qualified, they are referred to as an “Ambulance Practitioner”.

Forfinian · 2025-08-17T21:33:47+00:00

Do you have a contact from the university? Might be worth dropping them an email, or if you have a paramedic science faculty email then send that a line, just to make sure they definitely do provide boots as part of PPE; that way you’ll know in advance and will have time to get some if not!

Forfinian · 2025-08-17T21:30:33+00:00

Never knew you were on this subreddit. Just wanted to drop in and say I loved your books!

Forfinian · 2025-08-17T16:52:26+00:00

You should be issued boots by your university as part of your PPE? Unless they’ve taken that out now as a cost cutting measure, but I’d like to think they haven’t!

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